to the pol u ilting in the direction of Nading illness, and even at the risk of harming Grigorenko. We would have to alter our usual hlorarchy of values, placing our duty to our protection and to the project above our duty to the patient; and we know that we would have to take stope that would demonstrate -to Grigoronto, to others and to ourselves that we had done so. Before anything how ever, we would have to obtain troca Grigorenko, in advanca, his Informed consent.

We aplained to him what we had in mind, and what the potencial dangers were for bum, sina me were insisting cant be grantes permisadon not only to carry out the comptation, but also to publik ctn it in any way we vished Be actonowledged our wartIng nd copted our couch to the complan approval. Aller all, he said, bebed noch ing wore to lone. He had at rendy beca labeled tisane.

And so we propered a doci moat for Grigortalo's stone care that embodied these condido -a document that

under ordinary strom Stano, nown of us would have

da pacient to sten In thats can, however, we felt we had to forecall any future objec con that we had been bound to Grigortako by the usual di cal auths and abilgation and that in ettuct, we had pro coded under condition of ad vanda cantorahip. Grigortako mund the documeat in Rundan and stoned # wth, he said, 10 regret

military and caring acasway, trona c h he was udtad otth daduction in 184. Drated into the Red Army, he saw his first military action ta 1930 against the Japenosa, and his back wus injured in a greande plagioa. He was injured twice more in battle against the German

After the war, Grigortako joined the start of the Frunze Military Academy in Moscow; in 1948, he was appointed deputy chairman of the de partient of scleancro surda and then in 1958, chair

of the department of cybermedia. Menawile he w woning the degree of Mer of Military Science

La 1800, Grigoronto achieved his highest military rank major general. By the end of his military arter five year later, he run the author of more than articles in all tary tean, or of the canthod, and porned

a ou docondon, includ. ing the Order of Lanin, two Ordan d the Rod Broner, the Order of the Red Star, the Order of the Second World War, w ell as seves nilitary

ferred to a los port in the Fur Eur :

Then, Grigorento founded a 13-cember "Union for the Ro vival of Leninism" in 1983 and prepared and distributed lent. lets calling for a return to Leninist tenets and principle He was arrested and sent for his free psychiatric namin don at the Serbuky Institute of Forensic Puychiatry in Mar cow, where he was judged to be mentally ill. Hospitalized, bo was not related uncil the spring of 1905, after Khrust chor's tall.

Unable to obtain any part deo in his own feld, having los bols of car's pension be v torood to find wort, at age S8, as a porter and longsboro

an. He seat protest lotters to Prime Minister Kosyon Pravda and the K.G.B.; be openly complained about the lots of his position and his title, and he publicly demonstrated against the trials of promineat die dents.

In 1902, in response to an ap peal, he now to Tashket to be a deten words in a anal of desideat leaders. He was ar rested and seat to a Tasheet paychalatric conantatoa for

mtadion. That commi ston found him to be wtthout mental Indes. However, la an

al move. Grigoreale was transterred across the country to the Serbuky last auta la Moscow for a second

umtadion, where he wu, again, found to be mentally ill. Once more he was forcibly hospital and, this time more than touran. In 1974 he was released, and

ed his dissident activt de. In 1977, he roomved the shooch visa to visit his sca la New York, where he said he could obtain medical treat

at that was unavailable to raat home. Three months later, the Supreme Soviet muda decree, signed by Leo adid Brechnev, revolding his cittahip. and Grigorunico announced that he was sooldag asytumn in the United States.

IR cena, they agreed that Grigorate's d at was the route not of racional coaviction but, rather, of psychopo thology. According to their theory of his mental illness, Griporako was suffering troca a chronic paranoid condition that at times reached pey-, chode proportions and that caused him to act ia rays that had brought him into conflict with Soviet lav. Specifically, that illness caused in him a penchant for "Tetorratsa" a need to retorta society, to speak out and act out against authority and to focus himsel repeatedly and obettnately on dissident themea. In so acting and speaking, the theory held. Grigorenko was not in control of himself, was not responsible for the legal implications of his behavior and could be burned. as i, from attending his own onial and tesutying in ata owa defense. Grigorenko's illness. the Soviet psychiatrists also implied, may have been ag. gravated or partly caused by arteriosclerotic changes in the blood vessels supplying his brain.

The Re-examination

Grigoria's anx marriage in s anded ta dvorca 15 I years later. There son trom | that marranow live ia the

Soviet Union. He second mar. naga, to his curreat otta, Zinaida, walted in the birth of an on, Andere, who cont grated to the United States several years ago

The Dissideat

r

The Maa

Pyotr Grigorteich Grips renko es barn in 1997 to a Rua Orthodox POR family ta the Ukraine. Hla mother died at typhus wota be val His father rumourned to 1913, but the row wite aber doned the household within a your, soon after the father was called to serve in World Worl.

Griportato wed the art in hade village to join the Commu stat Youth League. Al the ne of LS,

b ox to the city of Do outat, bere he found work as a locttth and machinist and commodo schooling at right; at age , be joined the Commune Party. And it was the party that was him to a

Grtsonako had some small nel with Soviet authorities - he protested, for wampie, na instance of and Sardin in M academy - but his first surtod cinda atted troca a speech ho dettvered in 1901 a dotate to party conter

no ta Morcow. He called for the democratizadoa a party rules. He w promapely sortoped of his colegas statu. N about the same time, he wrot as gpa lotter to Mar cow voten antaising the T onable and area harmful activity of Khrushchev and his team." Grigortalo io mediately lost his position at the military scademy and within a hall year, was ruas

In order to evaluate Griga runko's paychiatric starus as accurately and fully as possible, we arranged for an unusually elaborate camination procedure. The interviews, totaling some aight hours, were carried out separately by uch of the paychiatrists. One we held at Harvard Univer sity and two in the videotape studio at the New York Suate Psychiatric Institute in upper Manhattan.

The questions asked of Grigorenko touched upon al most every dimension of his life, including his family, his earty memories, his sexual, intellectual and moral develop ment, his idees, his impulses, his spectations, his feelings and the nature of his personal relationships. Inevitably, we paid particular attention to his political ideas and to the motinations for his dissident acts. All of the interviews were car ned out through an interpreter, and all were recorded, two on videotape.

The Patient

Tivo comienion of forensic psychiatrists, boch from the Serbuty Institute in Moscow had recommended that Grigo renco be committed. Their Madings are virtually identi.

In addition, in order to invee Diante in depth those areas of poychopatholog cited in the Sovies reports, thrte special caninations were per formed all by consultants from the Harvard Medical School. A three hour battery of peychological tests was ad ministered by Irene P. Stiver, including the kinds of Interpre tive, projective tests (such as the Rorschach ink blor" test) that could reveal the presence of paranoid si And the question of an arteriosclerode brain condition affecting Grigorenko's thinlong, also noted in the Soviet diamordic reports, was investigated through a neurological camination by Norten Geschwind and an eight-tour battery of maropaychological tests by Bartun P. Joo...

Flamily, we submitted video taped interviews to the staff of the Bloocentes Research D partment at the New York State Psychiatric (edit Using the intormation on the tape, the morbers of the staff attempted to determine whether Grigorence sadded thotr reward criteria for a

diagnosts of Dental illo por pel

Griportate dou uma speak English. Dr. Barts zou bolc, who was in the mide at his poychiatre rudency at Columbia after having at prated from the Soviet Union in 1973, kepe Grigorendo io formed of our proceduru, adviood us on special aspects of Soviet diapostic definitions and provided us, as well as our comitants, with translation during all examination. Iron cally, Dr. Zoubok had received part of his medical training in Moroo under the very same Dr. Snezhnevsky who had urged that Grigorenko bero examined. For all his eatpor

titse, however, we were con | cerned that, as an emigrt, Dr.

Zoubok might be accused by the Soviets of having distorted Grigorenko's meaning in

order to cover any signs of ilInese. We arranged for three i obes Russian-speaking per

son to be present at the coraminations or to review the tapes. In the end, all of them found Dr. Zoubok's translations fully reliable.

GRIGORENKO: "No, this is not true. It's just that I bel ameloon I was just lucky that I became know, asuly as a result of the campaign in my detense (organized by his wife). There are many who did more than I did, but no one Imous about them."

PSYCHIATRIST: "Did God put it in their souls, too?"

GRIGORENKO: "I think so. I think that Providence plays a pracer role in the lives of peo pie chan we think."

PSYCHIATRIST: "Do you think that you have some kind of special relationship with God?"

GRIGORENKO: "N. Even though I firmly believe that God exists in the world, and that there is some Supreme Ronson, I unfortunately cannok absort myself fully in prayer...."

la exploring Grigorenko's way of relating to others and interpreting their behavior, we were especially interested in the possibility that, like a paranoid individual, he might beve tended to see all actions talog pink bs as part of plot designed to

Grigortako said that he al Interviews

ways understood the possible

consequences of his action. In and Findines

forming his Untou for the Ro

vival of Lenintso, for eam- Grigorenko is n large man of ple, he said that he had fully distinguished beartng with a expected to be shot: shaved head and a slow, some PSYCHIATRIST: "Why did what shutning pait. Although

you do that, then, if you somedmes quiet and subdued thought you might be shot?" during our interviews, be oftea GRIGORENKO: "It was be displayed considerable intes.

cause I couldn't acquiesce to est and animation. That was

the regime. I knew that I particularly true whea he vould not achieve anything by spole about his political ideas organizing (the union), that it and the change they had us

rould be discovered very derrame over the years and soon. But I thought that that also, when he remembered would awaken a moral feeling previously forgotten events in other people. ... Soviet psywith special clarity. pain or

chiatrists considered this to be satistaction. He was able, in

the main evidence for my response to direct questions, to mental disease, the fact that I recount aspects of his history entered into this activity with great precision, and he lonowing of its fucility. 11 reacted to the content of his American poychiatrists should memories with a broad and have the same opinion, I would full spectrum of responses, have to say, I would have to in ranging from sad regret to evi sist, that they're wrong." des enjoymeal, troon tactul We nied to pred him about redaction to obvious humor.

his motivation for continuing He established a relationship

in his dissent, despite the das with each of us quickly and gers and the frustrations. easily, and was able to share "It's not a personal cause," with w his mox distressing

bu said. "It's a social, com concert u

hie Jolie

mi can Socoon always about the meals, trumpa us to start ... This (Soviet) and ironia Hallite.

gyon a pu should He nowered our questions Noc bo tolerated by people, but fully and quad audi iter beppes that everyone Door and natu n aging it. There always been, from We copertona lewe to be people to startwith Soviet paychiatry, could then ochen will follow. And be construed under particular those who start, regardless of circumstance, as syroptoons whether or not they are talentor some of curtain poychiatntc d. or have special abilities condition.

they become a slogan, a ben Most of our questions were Der, for those who follow.... aimed at resolving the same of During my life, in my faithful Grigorenko's paranoid condi service to communism, I thon. 11 the Soviet dlagane and a lot of damage to tay vere correct, then some signs people, and I wanted, at least of that condition should still be in my rustning days, to re precot. And, 100, we should be pair it ... What's the sense of able to detect sips of it in his living one at year if you past as he presented it.

continue in the fraud of not We questioned Grigorealco facing things? It's better to at length about the moun live the rest of your life cres tions for his dissideat acts and tively so that you will not be ideas. Was be able to appreci. ashamed in the yes of your ate the dangers inherent in bots prandchildren. (At this point, actions? Did he have, or had Grigorenko appeared sad, but he ever had, paranoid reform continued to speak carefully ist delusions? Was he driven; and deliberately) I always as paranoids oftea are, by considered the inner impulse some unshakable beltet about to serve as a vocation inspired the world that had no com

- instilled in my soul - by spondence with realky? Did he

God. have an exalted, inflated view PSYCHIATRIST: "Why in of his own powers, a prenditore your soul? After all, only a few sense of himself as supertu people did what you did." Dan, pertapa a messenger of God?

Finally, wounted to clarify the quico tion of arteriosclerotic brain disease. It appears that in 1972 Grigorenko experienced a small strate that affected vision in his night cye. In addition, in his physical enamination, our consultant neurologist found evidence of arterosclerosis of the right internal carotid artery. However, nescher we mor our consultants, including our souropsychological consultant, found any evidence that the arteriosclerosis

as affecting Grigorenko's thinking. mood, behavior or character, or had dom so in the past

Conclusions

pernacute hin. Knowing that he was, in fact, followed by the K.G.B., and repeatedly investigated, we expected at the least, that he would stress those coperiences. We assumed he would semphasize the deviousness and vindictiveness of the authoride in arrusting him, in hospitalizing him, in stripping him of his rink and his officer's pension. Instead, he frequently patated to the decency, sincerity, hoc

ty and opennes of some of his ad versaries, including members of the Central Committee of the Communist Party.

Since the Soviet psychiatrists had cepanded at length on Grigorenko's personality characteria, streading those than Content with a diat nants of a parthold condition, made special attempts at identifying such character.de

Wested him, for comple, about a confrontadon he had had in 1900 art in from his master's dissertation to io first chapter, the dissertation hand contained implied criticisms of the miliary that a med, higto mning othon, dhe bed beda told to remonta Wecebed how he had responded to that advies, marching for evidence of a typically paranoid

bility to compromtoa. He wind that, after a while, bo hnd agreed to act the aridetom

We found other evidence of Grigo ronto's lledbility as well. During his first hospitalization, for example, he rovised his polldal ballets, rejecting the very sam. Lantnis nodion in

those dame be had carried out his Wegal dissident acts and for whose

l be bad boca unustod and boup talted.

And syutomatically sought other indication of any perunoid condition either now or in the past character istics, truits or signs ranging from the mont mild to the more soven Our poychological comitant made a simi lar attempt Sb, toa, w cods

la reviewing our tests, interviews and other caminations, we could find no evidence of montal illness in Grigo Mao, a conclusica contined inde pendeatly by the biometrics research

art of the New York State Psychiatnc Institute on the basis of their standardized evaluadian of our video taped interviews. Nor could we find

vidence la Grignonio's history con stunt with metal illness in the past In particular, there is no evidence of

y mental and in the paranoid e , avea of the wildest sort. While there is evideo, aa che basis of his tosand playacal Nadinga, of erterto

erotic densa, there is no sign that that condido ha s ificantly compromatrod Grigore co's intellectual or conocoon capacities, or that it has in any way formed or determined his behavior or mood. (A special session do che anamtandions thar led to those conclusions will be held Tuesday at the convention of the American Psycharic Asociation in Chicago)

La the rain, our that in codumtning Grigortako wa to look for sims of in

. What we found, instead, was a MAD - a man who, ironically, re minded win some ways of the patient in Soviet description. But their vershion af Grtorialow constantly slawod For where they claimed ob

lon, found perseverance: ar they cited delusion, we found radonality; where they identified paychodc rcdemens, found committed devocion, and where they diar nood patholog, we found health. I

APPENDIX 2

REMARKS BY MAX KAMPELMAN, CHAIRMAN OF THE U.S. DELEGATION

TO THE PLENARY SESSION OF THE COMMISSION ON SECURITY AND COOPERATION IN EUROPE, IN MADRID, ENTITLED “PSYCHIATRIC ABUSE IN THE SOVIET UNION,” FEBRUARY 24, 1982

Since we reconvened these meetings on February 9 many important words have been spoken here about the most recent of a continued pattem of Helsinki Accord violations, the violence : against the people of Poland. It is important to recall, however, that the excesses that disturb us in Poland are not only the result of Soviet military and political pressure, they reflect a pattern of even greater repression in Soviet society.

On Human Rights Day, in this Hali, the Soviet Delegate called our human rights concerns a "fuss being made over a bunch of dropouts"; he charged us with using "barefaced inventions" for the purpose of "damaging polemics." He obviously considers our expectation that the Soviet Union will observe its Helsinki commitments of 1975 to be an "undermining" of his country's "socio-political rights."

The Polish people understand, as the Final Act clearly directs, that human rights have directly to do with the individual's right to live in liberty and with dignity. Those who would redefine this concept by referring to economic and social rights of "masses" are attempting to obscure the absence of human rights in their own societies. Large groupings of people consist of individuals. Where the integrity of the human being is not respected, there are no human rights for the many. It is also noteworthy that those states who deny the human rights of the individual are unable to provide for his economic and social needs as well.

Recent news reports illustrate again with dramatic impact the consequences for a society and its people where there is a lack of concern and sensitivity for individual human rights. Allow me, Mr. Chairman, to give one vivid illustration of the extremes to which a failing society will go to suppress criticism of its own deficiencies.

In the Soviet Union, psychiatry, a healing science, has been perverted into an instrument of cruel political repression. Men and women, sane and exercising their rights as human beings under the Helsinki Final Act, have been, usually without trial, brutally condemned to the grotesque world of politically controlled psychiatric institution's, where they have been silenced

through drugs and violated in a manner reminiscent of the Middle Ages.

The logic of this travesty is cruel and simple: the authorities can commit a dissenter to a mental institution by administrative action. In the criminal commitment procedure, . the defendant can be ruled "not accountable" and ordered by the court to receive compulsory psychiatric treatment, without the right to participate in his own defense or be present at his own trial. The trial itself is closed to the public.

Psychiatric incarceration spares the authorities the embarrassment of staging full-scale trials of political dissidents; a person's views are discredited by calling them crazy. Indefinite sentences without the de facto right of appeal are then thrust upon those whose continued activity is a nuisance to the state. Once in an institution, the victim is administered powerful drugs with painful and debilitating side effects in order to induce recantation. Others on the outside are then dissuaded from exercising their rights by the threat of psychiatric institutionalization.

No wonder this practice led the Sixth World Congress of the World Psychiatric Association in 1977 unprecedentedly to single out the Soviet Union for condemnation! In recent weeks, as a result of yet new disclosures, the Royal College of Psychiatrists in England has voted to ask the World Psychiatric Association to expel the Soviet Union when it next meets in 1983.

We are all here aware that the repression of human rights in the Soviet Union has increased in intensity--clearly an act of defiance and disdain for this meeting and the Helsinki process. As part of that repression, all of the founding members of the Working Commission for the Investigation of the Use of Psychiatry for Political Purposes have also been imprisoned or exiled.

Let us examine this abnormal phenomenon in human terms, using a few current examples:

- Dr. Anatoly Koryagin, a consulting psychiatrist with the Working Commission had examined numerous people confined for alleged psychiatric illness and found them to be normal, sane individuals. For such activity he was sentenced last June to seven years in strict regimen camp plus five years internal exile. In taking his moral stand, Dr. Koryagin knew that Dr.